[RETRACTED ARTICLE] Comparison of Arndt-endobronchial blocker plus laryngeal mask airway with left-sided double-lumen endobronchial tube in one-lung ventilation in thoracic surgery in the morbidly obese

Abstract

This study aimed to evaluate the feasibility and performance of Arndt-endobronchial blocker (Arndt) combined with laryngeal mask airway (LMA) compared with left-sided double-lumen endobronchial tube (L-DLT) in morbidly obese patients in one-lung ventilation (OLV). In a prospective, randomized double-blind controlled clinical trial, 80 morbidly obese patients (ASA I-III, aged 20–70) undergoing general anesthesia for elective thoracic surgeries were randomly allocated into groups Arndt (n=40) and L-DLT (n=40). In group Arndt, a LMA™ Proseal was placed followed by an Arndt-endobronchial blocker. In group L-DLT, patients were intubated with a left-sided double-lumen endotracheal tube. Primary endpoints were the airway establishment, ease of insertion, oxygenation, lung collapse and surgical field exposure. Results showed similar ease of airway establishment and tube/device insertion between the two groups. Oxygen arterial pressure (PaO2) of patients in the Arndt group was significantly higher than L-DLT (154±46 vs 105±52 mmHg; P<0.05). Quality of lung collapse and surgical field exposure in the Arndt group was significantly better than L-DLT (effective rate 100 vs 90%; P<0.05). Duration of surgery and anesthesia were significantly shorter in the Arndt group (2.4±1.7 vs 3.1±1.8 and 2.8±1.9 vs 3.8±1.8 h, respectively; P<0.05). Incidence of hoarseness of voice and incidence and severity of throat pain at the post-anesthesia care unit and 12, 24, 48, and 72 h after surgery were significantly lower in the Arndt group (P<0.05). Findings suggested that Arndt-endobronchial blocker combined with LMA can serve as a promising alternative for morbidly obese patients in OLV in thoracic surgery.

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“…Body mass index (BMI), which acts as an indicator of body fat, has been reported to be related with adverse outcomes, including metabolic, respiratory, cardiovascular, and musculoskeletal, which can adversely impact surgical outcomes to a certain extent [10]. Some researchers demonstrated that obesity is an important risk factor for postoperative complications, and the rate of postoperative complication in obese patients is higher than that in patients with normal weight [11][12][13][14]. However, some other researchers disagreed with that and pointed out that obesity did not affect postoperative complications in some surgery [15][16][17][18].…”

Congenital Bronchobiliary Fistula: A Case Report and Literature Review

“…The BBF was cut off and sutured. At present, the commonly used single lung ventilation technology includes double-lumen bronchial catheter ventilation and endobronchial blocker blocking one side of the main bronchus (23,24). The smallest doublelumen bronchus tube is 26F.…”

The relationship between weight indices and injuries and mortalities caused by the motor vehicle accidents: a systematic review and meta-analysis

“…It is also difficult to maintain the airways of these people for surgery because of changes in the pulmonary mechanism and circulatory system. 57 It has been suggested that BMI> 35 (obesity) be considered as a precursor variable, and should be continuously measured and evaluated. 49 A direct relationship was observed between overweight and mortality due to MVA.…”